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"The promise of pharmacogenomics,
the study of the role of inheritance in the individual variation
in drug response, lies in its potential to identify the right
drug and dose for each patient."
New England Journal of Medicine, Vol. 348, No. 6, February
6, 2003
Pharmaceutical drugs do not affect all people equally. In
fact, people's response to drugs varies widely. You don't
hear much about this, but it's true that many common drugs
are effective in less than two-thirds of the people who take
them.
There is a branch of genetic medicine called pharmacogenomics
that is beginning to change how doctors prescribe drugs. It's
a form of genetic test that gives doctors the information
to customize drug therapy to individual patients based on
their individual genetic makeup.
This works because the way a person's body responds to drugs
is an inherited trait. Your genes determine which drugs will
work in your body and which will not have any effect. Variations
in genes can cause some people to suffer serious, even fatal,
side effects from what clinical trials determined was the
"normal" dose. This helps explain why there are
over 2 million adverse drug reactions each year in the U.S.
serious enough to cause hospitalization and over 100,000 deaths.
Adverse drug reactions are the fourth leading cause of death
in the U.S.
Pharmacogenomics allow doctors to "see" the genotype
of an individual patient and to customize drug therapy for
optimum effect and reduce drug dosage trial and error.
Pharmacogenomics applies not only to prescription drugs.
It can tell you how you will react to over-the-counter drugs,
herbal remedies, supplements and vitamins, recreational drugs
(nicotine, caffeine, cocaine, etc.), certain foods, and pollutants
in your environment.
How Pharmacogenomics Works
Pharmacogenomics begins with a gene test-a swab or blood
sample sent to a lab. The report is a full analysis of your
ability to metabolize a long list of specific pharmaceuticals,
OTC drugs, and herbals. And because your genetic makeup never
changes, the data can be used to improve treatment for the
rest of your life.
On a cellular level, pharmacogenomics looks at how drugs
are broken down in your body. Specifically, it takes into
account the enzymes that metabolize drugs. Variations in your
genes determine the balance of enzymes, causing some drugs
to be metabolized too quickly, others too slowly. Some essential
enzymes are missing altogether.
If a particular drug is metabolized too quickly, your body
eliminates it before it can do any good. It is ineffective.
To work, you need a higher dose or a substitute drug.
If a drug metabolizes too slowly, or not at all, the drug
accumulates in your bloodstream. This is worse than being
ineffective because it amounts to an overdose. Missing a certain
enzyme needed to break down the drug can lead to bad side
effects, and in the worst cases, death. If your doctor has
detailed information from a gene test on how you metabolize
drugs, he or she can prescribe that drug in a lower dose,
or use a different drug altogether.
The same is true for drug interactions. It gets complicated,
but armed with the data from a gene test, your doctor can
avoid certain drug combinations that either are ineffective
or cause harm.
Benefits of Pharmacogenomics
- Pharmacogenomics tests are available now to provide much
more accurate, personalized drug treatment-drugs prescribed
at the optimum dosage for your body to avoid adverse side
effects or death.
- Pharmacogenomics is a scientifically-based method for
learning how lifestyle, diet, over-the-counter drugs, and
recreational drugs affect your health.
- Pharmacogenomics helps your doctor determine the best
drug combinations to treat you without resorting to trial
and error methods.
- When pharmacogenomics becomes widespread, it will help
reduce overall health costs.
More Information
Links to additional information on pharmacogenomics, studies,
and case studies are available on the Resources
Page.
Pharmacogenomic testing packages can be obtained on the Products page.
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